CML treatment, which typically comes in the form of a daily pill, can come with some unpleasant side effects. Most people can manage the side effects and continue with their treatment. Here are some symptoms you might expect and how to get relief.
GI Problems
GI side effects are a pretty common consequence of almost all the standard drugs for CML.
Nausea and vomiting. It’s harder to get the nutrition and hydration you need to keep if you’re dealing with nausea and vomiting. That’s why it’s important to treat this symptom.
Don’t try any over-the-counter drugs for the problem unless you get the go-ahead from your doctor first. Your doctor may prefer to prescribe medicine for nausea and vomiting. Keep taking it even after you feel better, or your symptoms will most likely come back.
You can also make some adjustments to how you eat and drink:
- Don’t skip meals. An empty stomach can make nausea worse.
- Eat small meals and sip on drinks throughout the day rather than eating or drinking a lot at once.
- Go for dry, bland foods like crackers, toast, cereal, and pretzels.
- Avoid fried, spicy, and strong-smelling foods.
- Opt for cold foods, which might be easier to tolerate than hot ones.
- Drink water, ginger ale, and sports drinks with electrolytes.
- Talk to your doctor about ginger as a supplement for nausea relief. You can also try ginger tea, ginger gum, or ginger ale.
- Stay sitting upright after meals, don’t lie down.
Some tweaks to your habits and surroundings might help, too:
- Don’t use fragrances in your home, like air fresheners of any type and scented personal care products and cleaning supplies.
- Use a fan when you cook.
- Keep the lights low, as sometimes, bright lights can trigger nausea and a headache.
- Keep your home cool.
Call your doctor if you:
- Have symptoms after you take medicine and make these other changes
- Have severe stomach pain or headache
- Throw up blood
- Throw up your medicine
- Have signs of dehydration, like dark urine, too little urine, dry mouth, or extreme thirst
- Have a fever
Diarrhea. It’s important to address any diarrhea you get from your treatment since it can leave you dehydrated or malnourished if it goes on for too long.
First, make some changes to what you drink. Go for these:
- Clear liquids including water, ginger ale, sports drinks, and clear broth
- Water-based ice pops
- A full cup of water after every bowel movement to help replace the water you’re losing
Steer clear of these:
- Alcohol, caffeine, and other acidic drinks like orange juice
- Artificial sweeteners, like those found in diet or sugar-free drinks
- Milk and milk-based products, including ice cream
When you’re able to eat, stick with easily digestible foods like:
- Low-fiber grains such as white bread and white rice
- Soft fruits such as bananas and applesauce
- Well-cooked, seedless, skinless veggies
Stay away from:
- Spicy or fatty foods
- High-fiber fare like raw fruits and veggies and beans
- Artificial sweeteners like the ones you find in diet or sugar-free foods
Call your doctor if you have:
- Diarrhea for more than 2 days
- No control over your bowels
- Blood in your stool
- A fever or stomach cramping or pain
Constipation. Your doctor may prescribe a laxative or stool softener or recommend a fiber supplement. Over-the-counter products might be OK, too, but always ask your doctor first.
Besides medicine, you can try other steps to help get things moving:
- Get physically active every day.
- Gradually bump up your daily fiber intake until you reach 25 to 35 grams a day.
- Go for high-fiber foods like raw fruits and vegetables, beans and legumes, whole grains, and oatmeal.
- Drink 8 to 10 cups of fluids every day.
- Drink warm or hot drinks in the mornings.
Try plum or prune juice, starting with a half-cup a day.
Skin Troubles
Many CML treatments can bring on skin changes that might be uncomfortable or just unsightly.
Rash. For most rashes, your doctor can give you a corticosteroid – a cream for mild cases, a pill for the more severe stuff. This should clear it right up. If not, you might get a referral to a dermatologist.
Dry skin. You should be able to manage this one on your own without a prescription. Try these tips:
- Instead of lotion, use a thick unscented cream. Slather it on twice a day. One time should be within 15 minutes after showering.
- Avoid personal care and cleaning supplies that irritate your skin. Switch to unscented and sensitive-skin formulations.
- Avoid bath accessories and products that scratch or scrub your skin, like loofahs, sponges, bath brushes, body scrubs, and other “exfoliating” products.
- Shower, bathe, and wash your hands with warm water, not hot.
- For extremely dry, cracked skin, choose a moisturizer that has salicylic acid, urea, ammonium, or lactic acid in it. These help the skin hold water in.
Itching. Some of the same tricks for dry skin can help relieve itching, too.
Here’s what you can try:
- Switch to fragrance-free personal care and cleaning products.
- Look for skin creams that have menthol, camphor, or pramoxine.
Ask your doctor if you can take an allergy medicine called an antihistamine or if you might need a prescription steroid cream.
Aches and Pains
You might get muscle cramps or pain in your muscles, bones, or joints. Depending on the type of pain and how severe it is, your doctor might recommend OTC painkillers, or they might prescribe medication.
You might also benefit from nondrug approaches, such as:
- Physical therapy
- Exercise
- Massage
- Hot or cold compresses
- Acupuncture
If you can’t get relief for your pain, talk to your doctor.
Cold- and Flu-Like Symptoms
Many side effects of your CML medication might feel more like the symptoms of a cold or the flu.
Cold symptoms. You might have a cough, runny or stuffy nose, sneezing, or sore throat. Your doctor might ask questions, like whether it’s a wet or dry cough and how long it’s been going on. Depending on how you answer those questions, they may recommend OTC or prescription cold or allergy medicine to stop the cold symptoms.
Be aware that a dry cough and shortness of breath can also be signs of fluid around your lungs, a serious side effect of dasatinib (Sprycel). Call your doctor if you have these symptoms.
Upper respiratory tract infection. Those cold symptoms could be signs of a respiratory infection. One CML drug, asciminib (Scemblix), can raise your risk of this. Tell your doctor if you have these symptoms. You’ll need to get treatment for the infection.
Headache. Your medicine can bring on headaches as a side effect, or they can be a symptom of another problem, like anemia. Your doctor will need to rule out other problems. They might recommend OTC or prescription medicine for the pain.
You could also get some headache relief from nondrug approaches like:
- Acupuncture
- Massage
- Guided imagery
- Relaxation techniques
Fever. If you have a fever, call your doctor.
Fatigue
Feeling extremely tired and low on energy is a common side effect of many types of cancer treatment. You’ll need to learn to live with this lower energy level.
Here are some things that will help:
- Get regular physical activity every day.
- Take breaks.
- Eat a healthy diet that includes enough calories.
- Plan important activities around the times of day you have more energy.
- Explore complementary therapies like yoga, acupuncture, and massage.
Ask your doctor about medications and supplements that might help.
Fluid Retention
Also called edema, this side effect is swelling in the legs, feet, hands, arm, face, or belly that comes from your body holding onto fluid.
Your doctor might recommend:
- A water pill, also called a diuretic, to help you get rid of the fluid
- Diet and exercise changes
- Physical or occupational therapy to get the fluids moving
On your own, you can try these steps to feel more comfortable:
- Raise the swollen limb when sitting or lying down.
- Avoid standing for long periods or sitting with your legs crossed.
- Wear compression stockings, gloves, or elastic sleeves to help push fluids along.
Wear loose-fitting clothing and shoes.
More Serious Side Effects
CML medications can also come with more serious side effects that you should not try to manage on your own. These can include anemia, heart problems, and high blood pressure. Ask your doctor about the risks of the specific drug you take. Make sure you understand the warning signs of serious side effects and when you should call your health care provider.
Show Sources
Photo Credit: AsiaVision/Getty Images
SOURCES:
Leukemia & Lymphoma Society: “CML Treatment Side Effects.”
Cancer.net: “Managing Physical Side Effects.”
Leukemia & Lymphoma Society of Canada: “Taking Care of Your Body,” “Understanding Cancer-Related Fatigue and Brain Fog,” “Pain Management,” “Diarrhea and Constipation,” “Nausea and Vomiting.”
National Library of Medicine: “Upper Respiratory Tract Infection.”
Leukemia Research Foundation: “Managing Leukemia Treatment Side Effects.”
